Immobility

What is immobility?

Any condition or disease that requires complete bed rest or extremely limits your activity is considered immobility.  Any condition causing immobility for 6 months or longer increases the risk for bone loss that may lead to osteoporosis.

Why does immobility increase the risk for osteoporosis?

Individuals who are immobile are limited or unable to participate in weight-bearing activities. Weight-bearing activity is any physical activity in which your body works against gravity. It simply means that your feet and legs are supporting or carrying your weight. This type of exercise builds bone mass in youth and maintains it in adulthood. The inability to perform weight-bearing activity due to immobility can lead to bone loss. An extreme example of what happens to bones without weight-bearing activity is observed in space travelers. When there is no gravity putting pressure on the bone, astronauts lose bone mass even though they exercise in space.

When someone is immobile, the cells that make bone (osteoblasts) are not able to work as well.  In addition, there is more activity of the cells that breakdown bone (osteoclasts). People on bed rest have shown to experience drastic bone loss. During bed rest there is an increased loss of calcium and phosphorus in the urine and often higher blood calcium levels. If the person regains mobility, many of these blood and urine tests will return to normal and bone loss will stop.

How do I know if I am at increased risk for osteoporosis for other reasons?

Immobility for more than 6 months for any reason is one risk factor for osteoporosis.  In addition to immobility, there are other risk factors for osteoporosis that might affect you. It is important for you to assess all of your personal risk factors for osteoporosis. Choose the appropriate NYSOPEP Osteoporosis Risk Assessment, ” Osteoporosis Risk Assessment for Premenopausal Women“, for “Postmenopausal Women“, or “for Men” to help you better understand your risk factors for bone loss or osteoporosis.

How can I reduce the risk for bone loss and fracture if I have been or I am currently immobilized?

Physical activity is important not only for your bones but also to maintain your muscles and strength during immobility. Physical Therapists are trained to design adaptive exercise programs to address specific goals. It is important to speak to your healthcare provider to determine if a physical therapy consult can help in building an activity program for you, taking your medical condition into consideration.

Choosing other bone-healthy habits will help you promote strong bones. Bone healthy habits include:

Eat a variety of healthy (nutrient-rich) foods. Make half your plate vegetables and fruit, add lean protein, include whole grains, select heart-healthy fats, and remember to include a calcium-rich food or drink at each meal. For more information about healthy food choices, go to www.choosemyplate.gov

Reach and maintain a healthy weight. Eat the amount of calories and protein you need. The amount that you need will depend on your height, weight, age, and medical condition.

Get the calcium you need. It is recommended that adults consume 1000 to 1200 milligrams (mg) of calcium each day. It is best to get calcium from the foods you eat. Foods rich in calcium such as low fat dairy foods (milk, yogurt, cheese), dark green leafy vegetables (bok choy, broccoli, collard greens, kale, mustard greens, and turnip greens), canned fish (sardines, salmon) eaten with bones, or calcium-fortified (with calcium added) foods. Try to eat a calcium rich food at each meal. If you think that you are not getting the recommended amount of calcium in the foods you eat, it is important to consult with your healthcare provider to find out if a calcium supplement is right for you.

Get the recommended amount of vitamin D. There are only a few good natural sources of vitamin D including fatty fish such as catfish, eel, mackerel, salmon, sardines, tuna and shiitake mushrooms. Small amounts of vitamin D are added to all cow’s milk, some types of beverages (almond, coconut, rice, or soy beverages and orange juice), yogurt, cheese, and nutrition bars. Adults 50 years of age and above should consume 800-1000 IU or 20-25mcg daily. Your healthcare provider may recommend more vitamin D than above stated amounts based on your individual needs.

Don’t smoke. If you do, STOP. Call 1-800-NYQUITS for information about how to quit.

Limit alcohol. Before drinking alcohol, it is important to speak to your healthcare provider about possible interactions with your medication or your medical condition. Too much alcohol can be harmful for your bones and your overall health.

Take action to prevent falls. Most broken bones occur as a result of a fall that can be prevented. Some actions to prevent falls at home include using nightlights, removing or securing scatter rugs, and getting rid of clutter.

It is important to discuss your bone health with your healthcare provider. She or he will determine if and when a bone mineral density (BMD) test is right for you. After you have a BMD test, your healthcare provider will be able to tell you if you need an osteoporosis medication to reduce bone loss and decrease the risk for broken bones.